Journal Article

Discrimination in healthcare as a barrier to care: experiences of socially disadvantaged populations in France from a nationally representative survey

Ichou, Mathieu, Rivenbark, Joshua G.

2020

Overview

Background People in socially disadvantaged groups face a myriad of challenges to their health. Discrimination, based on group status such as gender, immigration generation, race/ethnicity, or religion, are a well-documented health challenge. However, less is known about experiences of discrimination specifically within healthcare settings, and how it may act as a barrier to healthcare. Methods Using data from a nationally representative survey of France ( N  = 21,761) with an oversample of immigrants, we examine rates of reported discrimination in healthcare settings, rates of foregoing healthcare, and whether discrimination could explain disparities in foregoing care across social groups. Results Rates of both reporting discrimination within healthcare and reporting foregone care in the past 12 months were generally highest among women, immigrants from Africa or Overseas France, and Muslims. For all of these groups, experiences of discrimination potentially explained significant proportions of their disparity in foregone care (Percent disparity in foregone care explained for: women = 17%, second-generation immigrants = 8%, Overseas France = 13%, North Africa = 22%, Sub-Saharan Africa = 32%, Muslims = 26%). Rates of foregone care were also higher for those of mixed origin and people who reported “Other Religion”, but foregone healthcare was not associated with discrimination for those groups. Conclusions Experiences of discrimination within the healthcare setting may present a barrier to healthcare for people that are socially disadvantaged due to gender, immigration, race/ethnicity, or religion. Researchers and policymakers should consider barriers to healthcare that lie within the healthcare experience itself as potential intervention targets.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Access to care / Adolescent / Adult / Africa South of the Sahara - ethnology / Africa, Northern - ethnology / At risk populations / Barriers / Behavior / Biostatistics / Delivery of Health Care / Demography / Disadvantaged / Disadvantaged persons / Discrimination / Emigrants and Immigrants - psychology / Emigrants and Immigrants - statistics & numerical data / Emigration and immigration / Environmental Health / Epidemiology / Equality / Ethnicity / Female / France / Gender / Group status / Health aspects / Health care / Health care disparities / Health care policy / Health Care Surveys / Health services / Health Services Accessibility / HIV / Human immunodeficiency virus / Humanities and Social Sciences / Humans / Immigrants / Immigration / Immigration policy / International health / Islam - psychology / Life Sciences / Male / Marital status / Medical care discrimination / Medical care quality / Medical law / Medicine / Medicine & Public Health / Middle Aged / Minority & ethnic groups / Minority groups / Multiculturalism & pluralism / Muslims / Noncitizens / Policy making / Polls & surveys / Population / Prejudice / Public Health / Quality of care / Race / Racism / Religion / Research Article / Santé publique et épidémiologie / Second generation / Setting (Literature) / Sexism / Social determinants of health / Social groups / Social inequality / Socioeconomic factors / Sociological Factors / Studies / Surveys / Vaccine / Vulnerable Populations - psychology / Vulnerable Populations - statistics & numerical data / Women / World health / Young Adult